Why the Best Mattresses for Back Sleepers Are Nearly All Medium-Firm

We asked three chiropractors for the cushion lowdown.
Morgan Bulman Avatar
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Photography by Amy Neunsinger

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Reading up on Domino’s shopping guides is like having your own personal product concierge. We do the tedious part—deep-dive research, hands-on testing, and tapping experts for advice—so all you have to do is hit “add to cart.” That’s why we call them Simply the Best.

Whether you prefer to sprawl out on your stomach or curl up on one side of the bed, everyone has a favored sleep position (or two). But if you want to prevent a crick in your neck come morning, there’s one method that’s more reliable than the rest: stretching out on your back. 

If you’re determined to say goodbye to aches and pains, you’ll need one of the best mattresses for back sleepers. According to Dr. Justin Lewis, a chiropractor at New York–based Get Adjusted, that means opting for a medium or medium-firm foundation. “This allows the mattress to conform to the natural curves of the body while supporting them simultaneously,” he explains. “By having this level of firmness, you prevent the heavier parts of your body from sinking too far,” which can throw everything out of balance. Our favorites, below (especially when paired with the perfect pillow), can help you kick-start your sound-sleep journey. 

Our Favorites

Best Overall: Avocado Green Mattress

Sleep trial: 365 nights | Type: Hybrid | Materials: Cotton, latex, wool | Warranty: 10 years  

What we like:

  • Every sustainable certification you can think of, Avocado has it 
  • Gentle level of firmness 
  • Needle tufted by hand for a luxe, quilted look 
  • Free of polyester and polyurethane 

Worth noting:

  • A bit heavy, but handles are sewn in to make adjustments less strenuous   
  • Pricey, especially if you add the pillow top

Why we chose it: This one effortlessly provides it all—supreme spine support; organic certifications; and a soft, cushiony feel—with free delivery, to boot. 

Not only does Avocado tick all the boxes—eco-friendly, that “just right” amount of firmness, hand-tufted details, and five different support zones—its Green Mattress comes highly recommended by Lewis. The standard, medium-firm option is particularly ideal: It’s also taken the best-overall spot in our best king mattresses guide. But are you surprised? Three inches of organic latex cover nearly 1,500 pocket coils that not only offer supreme edge support (no sagging here!) but ensure your body weight is evenly distributed, keeping your spine in line and softening contact with each of your pressure points, hips included. This is a mattress that hugs every nook and cranny, so it’s as comfortable as it is supportive. And yes, while it is an absolute dream for back sleepers, we also love the fact that you can trace back the wool to the company’s own herding collective, so you can sleep soundly and safely. And if you aren’t convinced (or your back still doesn’t feel quite right), you have a full year to decide whether or not to keep it. 

Best Value: Allswell Hybrid Mattress 

Sleep trial: 100 nights | Type: Hybrid | Materials: Memory foam | Warranty: 3 years, but can pay extra for extension up to 10 years  

What we like:

  • Less than $500 for a queen 
  • Mattress in a box
  • Cooling charcoal- and copper-infused foam 
  • Free shipping and returns 

Worth noting:

  • Need to pay extra to have your old mattress removed 
  • Only 3-year warranty 

Why we chose it: At a price that can’t be beat, this entry-level hybrid is great for first-time mattress buyers. 

Cut open the quilted top of this mattress and you’ll find a layer of charcoal- and copper-infused foam (hello, sweat-free nights) and a ton of individually wrapped coils for support. This means if you share the bed with a pet (or person) that tends to wake up during the night, motion transfer will be kept to a minimum and you’ll stay undisturbed. Other than that, you won’t uncover any other extras, but for the price, this no-frills deal can comfortably cradle back sleepers (and a number of side sleepers, too). Add to that the ideal medium-firm feel, and we couldn’t resist highlighting this as the best bang for your buck. If budget is your number-one priority, though, check out our other guide to some quality mattresses that won’t break the bank

Best Custom: Saatva Classic Mattress 

Sleep trial: 365 nights | Type: Hybrid | Materials: Cotton, foam | Warranty: Lifetime  

What we like:

  • Contouring, 3-inch Euro pillow top 
  • Free mattress removal and in-room delivery 
  • Choose between comfort levels: plush soft, luxury firm, and firm
  • Great edge support and lower back support 
  • Naturally cooling 

Worth noting:

  • Over $1,500 for a queen   

Why we chose it: Bring home the look and feel of a five-star hotel while carefully curating your precise comfort level. 

You can’t really go wrong with any Saatva mattress (its Youth mattress is our number-one pick for kids), but the Classic, an innerspring hybrid, comes with the added bonus of being relatively customizable. This could easily skew as an upgraded luxe pick (it’s actually our overall choice when it comes to mattresses for back pain), but the fact that you can select from a variety of sizes, heights, and comfort levels offers an unparalleled level of customization. Many back sleepers will appreciate the luxury firm, which falls somewhere in the medium to medium-firm range, which experts tell us is just the kind of balance your back needs. 

We’d have to say the biggest sell for back sleepers, though, is the patented Lumbar Zone technology; it’s clinically proven to reduce stiffness and alleviate back pain by pairing reactive, cradling coils with a cushiony memory foam layer. This, the company claims, helps keep your spine in check with an extra bit of support in the center third of the bed. Not convinced? You can try it out for a full year to see for yourself what the hype is all about. 

Best Cooling: Casper Wave Hybrid Snow Mattress 

Sleep trial: 100 nights | Type: Hybrid | Materials: Foam, latex | Warranty: 10 years  

What we like:

  • Free delivery 
  • Resilient springs for support also promotes airflow 
  • Textiles made from 121 recycled bottles 

Worth noting:

  • Priciest on our list   

Why we chose it: If you sleep hot, find sweet, sweat-free (and pressure point!) relief in the Wave. 

We’ll be up front: While Casper’s coveted Snow technology costs extra (like, $500 more), if you’re someone who runs hot all year long, be it the dead of winter or peak of summer, this is the mattress you need. In actuality, it’s great for sleepers of all persuasions, but it has all the features experts tell us to look for in the best mattresses for back sleepers: a hybrid construction, medium-firm feel, and breathable materials. Three cooling layers of perforated gel are sandwiched between even more layers of foam, including “HeatDelete bands” that refuse to allow the bed (and subsequently you) to absorb additional heat. And don’t forget the 86 gel pads that you’ll find aptly placed beneath your waist and lower back, so you’re less likely to sag into the material in those areas. It’s what the brand refers to as Zoned Support Max, and we think your spine will thank you for this later down the road. If not, just make sure to send it back before your 100-night, risk-free trial period is up. 

On Our Radar

Deluxe Wooly Mattress, Woolroom

$1500

Nate Berkus Mattress, Beautyrest

$2499

How We Chose These Products

To figure out which features to keep in mind while searching for the best mattresses for back sleepers, we made sure to tap three chiropractors, a sleep science coach, and a doctor specializing in sleep. Their expertise narrowed down the top features to the following: construction, materials, and firmness levels. We also made sure our list is a balance of style, high-quality manufacturing, and eco-conscious attributes. Our editors and writers conduct hands-on testing when possible, and we tap industry experts for their input, dig into brand stats, and conduct independent research. The thing is: There’s really no shortcut to finding an ideal mattress—you just have to try them! So we always strive to prioritize sleep trials.

Our Shopping Checklist

Types of Mattresses 

There is no specific type of mattress that’s the clear ideal for back sleepers. Sleep is vastly personal, but in general, chiropractor Dr. Robert Koser has found that most back sleepers prefer memory foam and hybrid mattresses. “The construction of these mattresses tends to provide more uniformity and offer sturdy support to the spinal column as we sleep on our back,” he notes. 

More specifically, Dr. Cody Hanish of Combined Clinics suggests looking for a hybrid with different zones of density. “When you lie on your side or back, your body places more pressure through your upper back and shoulders and through your pelvis and hips,” says Hanish. “Your head, mid-back, and legs don’t place as much pressure, so those zones require a different density. I also recommend that the springs be placed in a honeycomb pattern to help eliminate the sagging that most mattresses form after sleeping on them night after night after night.” 

Firmness Level 

“As a rule of thumb, people who mostly sleep on their back should start their shopping journey looking at medium-firm mattresses as a baseline for support and modify from there,” suggests Koser. “You may find that you need slightly more or slightly less support to be comfortable when lying down.”

This is because there are multiple curves in our spine, he continues, and a mattress with a little bit of give will be able to more easily (and naturally) contour around the spine. But more than anything else, comfortability is key. While this is a good generalization, it’s still important to note that mattresses for back sleepers are not a “one size fits all” situation, stresses Hanish. As long as your mattress offers zones of support for all the different pressure points, you’re good. “You can soften the mattress by placing a softer topper on the mattress,” he adds. 

Materials 

If you’re someone who catches most of their z’s lying on their back, more of your body surface is coming in contact with the mattress as compared to the more popular side sleeper. This means you’re more likely to heat up at a faster rate, so breathability is super-important. Fibers that naturally wick away heat and moisture, like cotton, are a great place to start. Or seek out gel-infused layers of memory foam, which specifically ensures your foam will dissipate heat rather than retain it. “Ideally you’d want a bed made out of soft, natural materials such as wool, combined with latex to provide optimal support and firmness,” shares Lewis. 

Trials and Warranties 

The best mattresses are always supported by a risk-free trial period; these are brands that are confident enough to stand by their mattress. The standard for this list offers 100 nights of experimental slumber, as evidenced by Allswell and Casper, but both Avocado and Saatva offer longer trials, up to an entire year. If you decide it isn’t a fit, we also appreciate companies that make sure to either repurpose, recycle, or donate those that didn’t meet a consumer’s needs in the end. 

But when you do finally commit, expect your mattress to last around a decade or so (though this greatly depends on the type of sleeper you are and the bed frame you own). Should anything seem a little out of the ordinary or faulty, there’s a good chance it’s covered in a warranty. Most offer up to that same 10-year timeline of protection, though our favorite brands offer even more: two extra years with Saatva, and our overall pick, Avocado, provides 25 years of protection. 

Ask Domino

Q: What’s the healthiest position to sleep in? 

If you’ve ever been asked whether you’re a stomach, side, or back sleeper, the latter is definitely the healthiest for your spine (at least when using the correct mattress), experts tell us.

Q: Is it possible to train myself to become a back sleeper? 

More often than not, it’s impossible to choose what position we naturally feel most comfortable in to sleep. “Sleeping positions are usually variable and based on a variety of individual preferences versus health-related ailments,” points out Dr. Abhinav Singh, medical director of the Indiana Sleep Center. “Normally we all change body positions between 20 and 30 times a night without knowing it. This is physiologic, because if we didn’t do this, we would wake up sore on a particular side that we slept on the entire night.” 

But if you don’t exactly want yourself unconsciously flipping over onto your stomach or side, there are ways you can convince your sleeping self to feel comfortable catching z’s on your back. For one, a pillow placed underneath your knees can alleviate any pressure on the spine. Reclining bed options are also helpful in this instance. 

Q: When it comes to soothing a bad back, what’s more important: the mattress or the pillow? 

Nearly all the experts we reached out to agreed: Both are important. “The right mattress helps keep the spine aligned, but the pillow is the trick to reducing neck and upper back pain,” explains Sleep Foundation’s sleep science coach and managing editor Logan Foley. “It’s important that your pillow and mattress work together to ensure your body can be comfortable while you sleep.”  

That’s why you’ll need to invest in a pillow with the right amount of support, adds Koser. “Our spines are divided into three parts: the cervical (neck), thoracic (mid-back), and lumbar (low back) regions,” he says. “While pillows provide important support for the top third of our spine in the neck, mattresses provide support for all three regions. For back sleepers especially, it’s so important that all regions of your spine are supported while you sleep.” 

When it comes to pillows, Lewis suggests a thinly contoured pillow to allow your head to settle in a neutral position. “You don’t want a large pillow that will force the head into flexion (basically forcing you to hunch) throughout the entirety of your sleep,” he says, adding you should look out for thin pillows that can support the natural “backward C” shape of the neck. 

Q: Anything I can do before bed to fall asleep faster? 

According to Singh, it’s all about your environment. “A warm shower prior to bed is a good idea as it warms up the skin, dilates the superficial blood vessels, facilitates heat loss from the periphery, and thereby cools the core of the body,” he offers. “Other factors such as a dark and noise-free environment are important.”

The Last Word

The best mattress for back sleepers is the one that you’ll snooze on most soundly. Bedding is relative, and if you’re trying to avoid back pain, you might also want to consider upgrading your pillow. But if you’re simply on the hunt for a mattress that is as cozy as it is supportive if you prefer lying on your back every night, you don’t have to look any further than our list.